Ntawm cov tshuaj rau kev kho mob ntshav siab (BP), Pyramil sawv. Cov tshuaj tiv thaiv kev ua si rau cov enzymatic hauv kev hloov pauv ntawm angiotensin I. Kev ua kom yuag thiab mob plawv. Ua tsaug rau kev sib koom ua ke ntawm ob lub tebchaw, nws thiaj li ua tau kom txo qhov kev pheej hmoo ntawm kev txhim kho myocardial infarction, mob stroke thiab nce tus nqi ntawm kev rov kho cov neeg mob uas muaj qhov txhab vascular system.
Lub Npe Tsis Yog Neeg Tsis Muaj Npe
Ramipril
Ntawm cov tshuaj rau kev kho mob ntshav siab (BP), Pyramil sawv.
ATX
C09AA05
Tso cov ntawv thiab cov nyob ua ke
Cov tshuaj muaj nyob hauv daim ntawv foos. Oblong biconvex ntsiav tshuaj muaj 5 lossis 10 mg ntawm cov tshuaj nquag ramipril. Raws li cov koomhaum pabcuam hauv cov khoom siv tau siv:
- colloidal silicon dioxide;
- glyceryl dibehenate;
- microcrystalline cellulose;
- glycine hydrochloride;
- pregelatinized hmoov txhuv nplej siab.
5 mg ntsiav tshuaj yog lub teeb xim liab vim qhov sib ntxiv ntawm xim liab raws xim hlau. Kev phom sij tsuas yog nyob ntawm sab xub ntiag xwb.
Microcrystalline cellulose yog siv los ua cov pabcuam hauv kev tsim cov Pyramil.
Pharmacological kev txiav txim
Cov tshuaj yog zwm rau ACE inhibitors (angiotensin-hloov enzyme). Thaum nws nkag mus rau hauv daim siab, cov tshuaj lom neeg lub cev sib xyaw ua ke hydrolyzes los ua cov khoom lag luam nquag - ramiprilat, uas ua rau tsis muaj zog ntawm ACE cov nyhuv (angiotensin-hloov mus rau enzyme nrawm qhov hloov pauv ntawm angiotensin I mus rau angiotensin II hauv kev hloov tshuaj lom neeg).
Ramipril inhibits plasma concentration ntawm angiotensin II, txo cov kev zais ntawm aldosterone thiab tib lub sijhawm txhim kho cov nyhuv ntawm renin. Hauv qhov no, kinase II blockade tshwm sim, prostaglandin ntau lawm nce thiab bradycardin tsis tawg. Raws li qhov txiaj ntsig ntawm qhov yeeb yam ntawm cov tshuaj nquag, txhua qhov kev tawm tsam ntawm cov leeg ntshav tsis muaj zog (OPSS) poob qis, vim tias lawv nthuav.
Cov Tshuaj Pharmacokinetics
Thaum muab ntawm qhov ncauj, cov tshuaj sai sai rau hauv txoj hnyuv, tsis hais cov pluas noj. Hauv qab ntawm esterase, hepatocytes yauv pauv hloov ntawm ramipril rau ramiprilat. Cov khoom lwj txiav cov khoom thaiv angiotensin-hloov ua enzyme 6 lub sijhawm muaj zog dua li cov ramipril. Cov tshuaj nce mus txog qhov siab tshaj plaws ntshav plasma hauv ib teev tom qab kev tswj hwm, thaum tus nqi siab tshaj plaws ntawm ramiprilat raug kuaj pom tom qab 2-4 teev.
Thaum nws nkag rau hauv cov ntshav, cov nquag sib xyaw khi rau cov ntshav plasma los ntawm 56-73% thiab pib muab faib rau thoob cov nqaij. Ib nrab-lub neej ntawm cov tshuaj nrog ib qho siv yog 13-17 teev. Ramipril thiab cov metabolite nquag tau tawm los ntawm ob lub raum los ntawm 40-60%.
Ramipril thiab cov metabolite nquag tau tawm los ntawm ob lub raum los ntawm 40-60%.
Kev ntsuas rau siv
Cov tshuaj yog tawm rau kev kho thiab tiv thaiv ntawm cov kab mob hauv qab no:
- nephropathy ntawm hom mob ntshav qab zib thiab tsis mob ntshav qab zib nyob rau hauv theem preclinical lossis tsev kho mob, nrog rau mob ntshav tawm ntawm cov leeg ntshav, proteinuria thiab tso cov albumin hauv cov zis;
- ntshav qab zib mellitus nyuaj los ntawm cov kev pheej hmoo ntxiv hauv daim ntawv ntawm kev tawg, nce lossis qis dua cov roj (cholesterol) thiab cov lipoproteins tsawg ntom, cov cwj pwm tsis zoo;
- kev mob ntshav siab hauv cov hlab ntsha loj;
- mob plawv tsis zoo, uas tau tsim tawm hauv 2-9 hnub tom qab lub plawv nres.
Cov tshuaj pab txo qis kev pheej hmoo ntawm cov neeg mob rov qab los ntawm kev hla kev ntawm txoj hlab ntshav leeg lossis hlab ntsha hlab plawv, mob plawv nres, mob plawv ntawm cov hlab ntshav txhaws, mob hlab ntsha tawg. Cov tshuaj yog ib feem ntawm txoj kev kho ua ke rau lub siab mob plawv.
Cov Yuav Tsum Muaj
Hauv qee kis, cov tshuaj tsis pom zoo lossis txwv tsis pub siv:
- mob raum lossis daim siab tsis txaus;
- cardiogenic poob siab;
- ntshav siab yog tias systolic siab qis dua 90 hli Hg. st .;
- hyperaldosteronism;
- stenosis ntawm mitral valve, aorta, hlab ntsha txhaws;
- obstructive cardiomyopathy;
- cev xeeb tub thiab lactation;
- cov menyuam yaus hnub nyoog qis dua 18 xyoo;
- nce kev cuam tshuam ntawm cov ntaub so ntswg mus rau cov qauv hauv cov tshuaj.
Ceev faj yog qhia thaum noj tshuaj tiv thaiv kab mob, tshuaj tua kab mob, tshuaj tua kab mob.
Li cas los noj Pyramil
Cov tshuaj yog npaj rau hauv lub qhov ncauj. Kev noj tshuaj txhua hnub thiab lub sijhawm ntawm txoj kev kho yog txiav txim los ntawm tus kws kho mob koom nrog raws tus yam ntxwv ntawm tus neeg mob, keeb kwm kho mob thiab kuaj ntshav. Lub luag haujlwm tseem ceeb hauv kev txiav txim siab cov txheej txheem kho yog ua si los ntawm qhov mob hnyav thiab hom mob.
| Tus kab mob | Txoj kev kho tus qauv |
| Tawg siab | Thaum tsis muaj lub siab tsis ua haujlwm, txhua hnub mus txog 2.5 mg. Cov tshuaj nce siab txhua 2-3 lub lis piam nyob ntawm qhov kam rau ua. Thaum tsis muaj kev kho mob kom zoo nrog kev noj tshuaj txhua hnub ntawm 10 mg ntawm cov tshuaj, nws yog qhov yuav tsum tau sab laj nrog koj tus kws kho mob txog kev teem caij kho mob kom zoo. Qhov siab tshaj plaws tau tso cai noj tshuaj yog 10 mg ib hnub twg. |
| Mob plawv nres | 1.25 mg rau ib hnub ib zaug. Cov koob tshuaj tau nce nce txhua 1-2 lub lis piam nyob ntawm tus neeg mob lub sijhawm. Tus nqi niaj hnub los ntawm 2.5 mg thiab siab dua yog pom zoo muab faib ua 1-2 koob. |
| Txo kev pheej hmoo ntawm mob hlab ntsha tawg, mob plawv nres | Kev noj tshuaj ib hnub rau ib zaug yog 2.5 mg. Hauv 3 lub lis piam tom ntej no, kev nce ntxiv rau hauv cov tshuaj tau tso cai (txhua 7 hnub). |
| Lub plawv tsis ua haujlwm tom qab lub plawv nres | Txoj kev kho mob pib 3-10 hnub tom qab lub plawv nres. Thawj koob tshuaj yog 5 mg rau ib hnub, muab faib ua 2 koob tshuaj (thaum sawv ntxov thiab ua ntej mus pw). Tom qab 2 hnub, qhov kev cai niaj hnub nce mus txog 10 mg. Nrog rau qhov ua siab tsis taus rau kev pib muab rau 2 hnub, tus nqi niaj hnub txo mus rau 1.25 mg rau ib hnub. |
| Ntshav qab zib thiab tsis mob ntshav qab zib nephropathy | 1.25 mg rau kev siv ib leeg, nrog tom qab nce ntxiv txog 5 mg. |
Nrog ntshav qab zib
Thaum pib theem ntawm kev kho tshuaj, nws raug nquahu kom noj ib nrab ntsiav tshuaj ntawm 5 mg ib hnub ib zaug. Ua raws li lub xeev dhau los ntawm kev noj qab haus huv, qhov niaj hnub niaj hnub tuaj yeem muab ob npaug rau qhov siab ntau kawg ntawm 5 mg nrog kev cuam tshuam ntawm 2-3 lub lis piam.
Sab Sij Huam Pyramil
Cov kev tsis zoo ntawm kev noj tshuaj yog tshwm sim nyob ntawm tus neeg qhov tshuaj tiv thaiv ntawm lub cev mus rau cov tshuaj sib txuas ntawm cov tshuaj nquag.
Ntawm ib feem ntawm cov khoom hauv nruab nrog kev pom
Kev pom tseeb tseeb txo qis, defocusing thiab plooj tshwm. Muaj qee zaus, mob qog nqaij hlav.
Los ntawm cov leeg nqaij thiab pob txha sib txuas
Lub cev cov leeg ua haujlwm nrog cov tsos mob tshwm sim ntawm cov leeg mob thiab mob pob txha.
Kev kho mob txoj hnyuv
Cov kev xav tsis zoo ntawm lub plab zom mov thaum siv tshuaj yeeb tshuaj pom lawv tus kheej hauv daim ntawv ntawm:
- mob thiab tsis xis nyob hauv thaj av epigastric;
- raws plab, mob plab, quav tawv;
- ntuav, xeev siab;
- dyspepsia;
- qhov ncauj qhuav
- tsis qab los noj mov nce mus rau kev txhim kho ntawm tus neeg mob anorexia;
- pancreatitis nrog kev muaj feem tsawg ntawm kev tuag.
Tej zaum muaj qhov nce hauv cov kev ua ntawm aminotransferases nyob rau hauv hepatocytes, hepatocellular tso nyiaj. Muaj kev tso pa tawm ntawm cov kua txiv pancreatic, qhov nce ntxiv ntawm cov ntshav plasma concentration ntawm bilirubin hauv cov ntshav, vim tias cholestatic jaundice muaj peev xwm tsim tau.
Hematopoietic plab hnyuv siab raum
Tawm tsam keeb kwm ntawm kev siv tshuaj kho mob, muaj qhov ntxim nyiam ntawm kev rov qab hloov agranulocytosis thiab neutropenia, txo qis cov qe ntshav thiab qib hemoglobin.
Nruab nrab hauv lub paj hlwb
Phiv los ntawm lub hauv nruab nrab thiab peripheral lub paj hlwb tau pom tias:
- kiv tob hau thiab mob taub hau;
- tsis hnov;
- parosmia;
- kev hnov hlawv;
- tsis tshuav nyiaj li cas;
- tshee hnyo ntawm nqua.
Kev ua txhaum ntawm kev puas siab ntsws, kev ntxhov siab, ntxhov siab, pw tsaug zog yog pom.
Los ntawm cov kab mob zis
Muaj qhov nce ntawm glomerular filtration disturbance, vim tias cov protein muaj nyob hauv cov zis, thiab theem ntawm creatinine thiab urea hauv cov ntshav nce.
Muaj qhov nce ntawm glomerular filtration disturbance, vim tias cov protein muaj nyob hauv cov zis, thiab theem ntawm creatinine thiab urea hauv cov ntshav nce.
Los ntawm lub tshuab ua pa
Cov kev mob tsis zoo ntawm cov txheej txheem ua pa yog pom nyob rau hauv daim ntawv ntawm mob ntsws, ua hnoos qhuav qhuav, ua tsis taus pa, mob ntsws.
Ntawm ib sab ntawm daim tawv nqaij
Cov neeg mob uas muaj lub siab xav tias muaj qhov tsis haum muaj qhov tsis haum ntawm daim tawv nqaij dermatitis, urticaria thiab hyperhidrosis. Photosensitization yog tsawg - rhiab heev rau lub teeb, alopecia, zuj zus cov tsos mob ntawm psoriasis, onycholysis.
Los ntawm genitourinary system
Hauv cov txiv neej, thaum lub sijhawm kho tshuaj, txo qis potency yog ua tau rau txoj kev txhim kho erectile kawg (impotence) thiab gynecomastia.
Los ntawm cov hlab plawv system
Cov kev mob tshwm sim los ntawm cov tshuaj rau hauv cov ntshav ncig hauv lub cev muaj qhia nyob rau hauv daim ntawv ntawm cov mob hauv qab no:
- orthostatic hypotension;
- arrhythmia, tachycardia;
- vasculitis, Raynaud's syndrome;
- ntu khoom haum;
- yaug ntsej muag.
Tawm tsam keeb kwm yav dhau los ntawm stenosis ntawm cov hlab ntsha cov hlab ntsha, kev txhim kho ntawm txoj kev mob ntshav yog ua tau.
Endocrine system
Raws li txoj kev xav, cov tsos ntawm kev tsis tuaj yeem tsim cov tshuaj tiv thaiv antidiuretic yog qhov ua tau.
Ntawm ib sab ntawm daim siab thiab cov hnyuv
Txoj kev pheej hmoo ntawm kev tsim kab mob siab thiab cholecystitis tau nce.
Los ntawm ib sab ntawm cov metabolism
Cov ntsiab lus ntawm cov poov tshuaj nyob rau hauv cov ntshav nce.
Kev ua xua
Nyob rau hauv muaj qhov pom kev tsis haum siab rau ramipril thiab ntu ntawm Pyramil, kev tsis haum tshuaj hauv qab no tuaj yeem tshwm sim:
- mob hlwb;
- Tus kab mob Stevens-Johnson;
- xoo pob, khaus, erythema;
- alopecia;
- anaphylactic poob siab.
Cuam tshuam rau lub peev xwm los tswj cov tshuab
Nyob rau lub sijhawm kho cov tshuaj no, nws raug nquahu kom tsis txhob tsav tsheb, sib cuam tshuam nrog cov txheej txheem tsis yooj yim, thiab los ntawm lwm cov haujlwm uas yuav tsum muaj kev kub siab thiab cuam tshuam sai.
Thaum lub sijhawm kho cov tshuaj, Nws raug nquahu kom tsis txhob tsav tsheb.
Cov lus qhia tshwj xeeb
Ua ntej pib siv tshuaj kho mob, nws yog ib qho tsim nyog yuav tsum sau rau hauv sodium tsis txaus thiab tshem tawm hypovolemia. Tom qab noj thawj koob, cov neeg mob yuav tsum nyob hauv kev saib xyuas kev noj qab haus huv rau 8 teev, vim tias muaj kev pheej hmoo ntawm kev txhim kho orthostatic hypotension.
Nyob rau hauv qhov muaj cholestatic jaundice, keeb kwm ntawm edema, nws yog ib qho tsim nyog kom tsum tsis txhob noj cov tshuaj. Hauv lub sijhawm rov ua kom zoo dua tom qab kev ua haujlwm los ntawm kev siv tshuaj loog, kev txo ntshav siab yog qhov ua tau, yog li, cov tshuaj yuav tsum tau muab tshem tawm 24 teev ua ntej kev phais.
Siv rau lub sijhawm qub
Ceev faj yog qhia paub thaum coj los ntawm cov neeg muaj hnub nyoog 65 xyoos vim nce qhov muaj feem ntawm kev mob raum, mob plawv thiab siab.
Txiag tej menyuam
Nws raug txwv tsis pub siv mus txog 18 xyoo.
Siv thaum cev xeeb tub thiab lactation
Cov tshuaj muaj cov teratogenic ntxim rau lub embryonic kev loj hlob ntawm tus me nyuam hauv plab, yog li ntawd, noj Pyramil thaum lub sijhawm npaj lossis cev xeeb tub yog txwv tsis pub.
Thaum lub sij hawm kho cov tshuaj, nws yog qhov pom zoo kom tsis txhob lactation.
Daim ntawv thov rau lub raum khiav tsis zoo
Cov tshuaj yuav tsum tsis txhob noj nrog creatinine tshem tawm tsawg dua 20 ml / min. Ceev faj yog qhia nyob rau hauv cov neeg mob tom qab hloov raum.
Siv rau lub siab ua haujlwm tsis zoo
Kev ceev faj yuav tsum tau siv thaum lub siab tsis ua haujlwm zoo. Hauv kev ua txhaum loj, kev txais tos ntawm Pyramil yuav tsum tau lawb tawm.
Overdose pyramil
Nrog kev tsim txom ntawm cov tshuaj, overdose tshwm sim yog pom:
- tsis meej pem thiab tsis nco qab;
- neeg ruam;
- lub raum tsis ua haujlwm;
- poob siab
- ua txhaum ntawm cov dej-ntsev sib npaug hauv lub cev;
- poob hauv cov ntshav siab;
- bradycardia.
Yog tias tsawg dua 4 teev tau dhau mus tom qab siv ib qhov tshuaj kho siab, ces nws yog qhov tsim nyog rau tus neeg mob ua kom qaug dab peg, yaug lub plab, thiab muab ib qho adsorbent. Kev qaug cawv hnyav, kev kho mob yog ua kom rov qab tso ntshav electrolytes thiab ntshav siab
Kev cuam tshuam nrog lwm yam tshuaj
Nrog rau kev tswj hwm Pyramil tib lub sijhawm nrog lwm cov tshuaj, cov tshuaj tiv thaiv tau pom hauv qab no:
- Cov tshuaj uas muaj cov ntsev ntsev ntsev lossis ua kom muaj ntshav ntau ntau ntxiv thiab cov tshuaj heparin ua rau hyperkalemia.
- Kev poob siab hauv lub siab yog qhov muaj peev xwm txuam nrog cov tshuaj tsaug zog, tshuaj ua kom tsaug zog thiab tshuaj yeeb dej caw.
- Txoj kev pheej hmoo ntawm kev txhim kho leukopenia hauv kev sib xyaw nrog ramipril nrog allopurinol, corticosteroids, procainamide yog nce ntxiv.
- Nonsteroidal anti-inflammatory tshuaj tsis muaj zog cov nyhuv ntawm Pyramil thiab ua rau muaj kev pheej hmoo ntawm lub raum tsis ua haujlwm.
- Ramipril tsub kom muaj qhov ceeb ntawm anaphylactic thaum lub sijhawm yoov tom.
Kev tsis sib xyaw yog pom nyob rau hauv kev sib xyaw nrog cov tshuaj muaj aliskiren, nrog angiotensin II antagonists, stabilizers ntawm cov cell ua ib ce.
Cawv tau zoo
Thaum noj tshuaj ethyl cawv, nws muaj peev xwm txhim kho lub chaw soj ntsuam cov duab vasodilation. Ramipril txhim kho kev ua kom lom rau ethanol rau daim siab, yog li thaum noj Pyramil, koj yuav tsum tsis txhob haus cawv.
Analogs
Tus qauv analogues ntawm Pyramil suav nrog:
- Amprilan;
- Cov ntsiav tshuaj Pyramil Ntxiv;
- Pob Tsuas;
- Dilaprel.
Hloov mus rau lwm cov tshuaj yog ua tiav tom qab sab laj nrog kws kho mob.
Cov ntsiab lus ntawm lub tsev muag tshuaj tawm
Cov tshuaj yog muag los ntawm tshuaj.
Kuv tuaj yeem yuav yam tsis tas yuav tshuaj
Vim tias muaj qhov pheej hmoo ntau ntxiv ntawm kev txhim kho kev tsis zoo ntawm lub cev, qhov muag dawb ntawm Pyramil yog txwv tsis pub.
Tus nqi Pyramil
Tus nqi nruab nrab ntawm cov tshuaj txawv ntawm 193 txog 300 rubles.
Cia rau cov neeg mob rau cov tshuaj
Nws raug nquahu kom cov tshuaj nyob hauv qhov chaw qhuav, tiv thaiv los ntawm tshav ntuj, ntawm qhov kub txog + 25 ° C.
Hnub tas sij hawm
2 xyoos
Chaw tsim tshuaj paus
Sandoz, Slovenia.
Pyramil tshuaj xyuas
Tatyana Nikova, 37 xyoo, Kazan
Tus kws kho mob tau tshaj tawm cov ntsiav tshuaj Pyramil vim tias kuv muaj mob ntshav siab ntev. Siab nce rau yav tsaus ntuj tau hnov qab txog 2 xyoos. Tab sis koj yuav tsum tau noj cov tshuaj tas li. Cov nyhuv tsis tau txais kev cawmdim. Kuv nyiam tus nqi zoo rau nyiaj. Ntawm cov kev mob tshwm sim, Kuv tuaj yeem paub qhov txawv hnoos qhuav.
Maria Sherchenko, 55 xyoo, Ufa
Kuv noj tshuaj txo qis tom qab mob stroke. Ntau leej tsis pab, tab sis tom qab ntawd tau ntsib Pyramil. Thaum xub thawj, tsis muaj tshwm sim vim qhov ntsuas me me, tab sis tom qab 2 lub lis piam qhov tshuaj tau nce ntxiv, lub siab pib poob qis. Kuv zoo mloog, tab sis ntsib nrog kev tsis sib xyaw ntawm cov tshuaj nrog tus naj npawb ntawm cov tshuaj. Pom txoj kev sib txuam zoo yog qhov nyuaj.
